Purpose The aim of this study was to assess white-to-white (WTW) horizontal corneal diameter using Pentacam versus IOLMaster and determine whether the two instruments were interchangeable.
Patients and methods Twenty eyes were included in this prospective clinical study conducted in I-care Eye Centre, Alexandria. Measurement of WTW horizontal corneal diameter was taken using Pentacam (internal and external measurements) and IOLMaster.
Results The mean WTW measured using IOLMaster was 11.66 ± 0.27 mm, ranging from 11.30 to 12.30 mm. The mean WTW externally using Pentacam was 11.93 ± 0.43 mm, ranging from 11.01 to 12.66 mm. The mean WTW internally using Pentacam was 11.20 ± 0.39 mm, ranging from 10.56 to 11.93 mm. The diameters measured using IOLMaster were significantly less than that measured using Pentacam externally and significantly more than that measured using Pentacam internally. There was no correlation between WTW measured using the two machines.
Conclusion Although horizontal corneal diameter (WTW) can be measured using Pentacam or IOLMaster, WTW measurement is significantly different between the two instruments and they should not be used interchangeably. Pentacam measurement depends on manual placement of calipers on the Scheimpflug digital image.

Purpose The aim of this work was to evaluate the posterior hyaloid changes and the effect on the vitreomacular relationship following intravitreal injection of ranibizumab (lucentis) for DME in diabetic patients attending the outpatient clinic of the Ophthalmology Department in Alexandria Main University Hospital.
Patients and methods The study included 40 eyes. All of them received a baseline injection of 0.5 mg of intravitreal ranibizumab under sterile conditions. The injection was performed under topical anesthesia, with or without sedation. Further injections were administered Pro Re Nata (PRN ‘as required’) as decided in each subsequent follow-up visit if central retinal thickness remained 300 μm or greater or if there was a decrease in best-corrected visual acuity due to DME progression, confirmed with clinical evaluation and/or optical coherence tomography or other anatomic and clinical assessments.
Results There were 12 male (54.2%) and 10 female patients (45.5%) between 45 and 71 years of age, with a mean value of 63.2 ± 12.6. There were five patients (22.7%) with type I and 17 patients (77.3%) with type II DM. The duration of DM was less than 10 years in six patients (27.3%) and more than 10 years in 16 patients (72.7%); it ranged between 9.5 and 20 years, with a mean value of 15.11 ± 7.98 years. HbA1c ranged from 7.11 to 8.25, with a mean value of 7.72 ± 0.892, and baseline visual acuity (TTDRS) ranged from 7.11 to 8.25, with a mean value of 53.13 ± 12.22. Baseline central macular thickness ranged from 301.0 to 525.0, with a mean value of 413.0 ± 107.0. No vitreous separation (category 1) was observed in 19 cases (47.5%), partial vitreomacular separation (VMS) (category 2) was observed in 12 cases (30%), vitreofoveal attachment with no traction (category 3) in seven cases (17.5%), and finally vitreofoveal attachment with traction (dome-shaped profile) (category 4) was observed in two cases (5%). No changes in vitreomacular relationship was seen in 16 cases (40%), partial VMS was seen in six cases (15%), vitreofoveal attachment with no traction was seen in eight cases (20%), vitreofoveal attachment with traction (dome-shaped profile) in three cases (7.5%), and complete VMS was seen in seven cases (17.5%). There was a statistically significant difference with regard to number of changes in VMR, partial VMS, vitreofoveal attachment with no traction, and vitreofoveal attachment with traction (dome-shaped profile). There was a statistically significant difference with regard to partial VMS, vitreofoveal attachment with no traction, and vitreofoveal attachment with traction (dome-shaped profile). There was a statistically significant relation between the number of injections and the outcome; the higher the number of injections, the better is the outcome.

Purpose The aim of the present study was to compare the results of Descemet's stripping automated endothelial keratoplasty (DSAEK) and ultrathin Descemet's stripping automated endothelial keratoplasty (UT-DSAEK) that were performed with a standardized technique at a single institution.
Design The present study was designed as a single-center, prospective, randomized nonblinded study.
Participants and methods Sixty-one and 51 eyes underwent DSAEK and UT-DSAEK, respectively, for any endothelial disease at the ‘Villa Igea’ Center. Patients with pre-existing ocular comorbidity that impacted visual potential such as macular degeneration, amblyopia, advanced glaucoma, and other optic neuropathies were excluded from the study. Best-corrected visual acuity (BCVA) (in Snellen acuity chart) was obtained and specular microscopy of donor corneal tissue was performed before surgery. Postoperative complications, BCVA, and the percent of endothelial cell loss (ECL) recorded at 1, 3, 6 months, and 1 year were compared.
Main outcome measures Visual acuity improvement, ECL, intraoperative postoperative complications, iatrogenic primary graft failure, and rebubbling were the main outcome measures in this study.
Results Mean ± SD BCVA improved from 0.17 ± 0.13 and 0.19 ± 0.13 before surgery to 0.75 ± 0.18 and 0.88 ± 0.19 at 1 year after DSAEK and UT-DSAEK, respectively (P = 0.001). ECL was 33.88 ± 17.74% after DSAEK and 36.37 ± 13.10% after UT-DSAEK (P = 0.4080). There were no iatrogenic primary graft failures after the two procedures but there were two late endothelial failures after DSAEK. Rebubbling was performed for four of 51 eyes after UT-DSAEK and for none after DSAEK (P = 0.04).
Conclusion Compared with DSAEK, UT-DSAEK provided better visual recovery and comparable ECL. The UT-DSAEK group had a higher percentage of rebubbling procedures but less rejection and failure rate.

Purpose The aim of the present study was to compare the pupil diameter in cases injected with intracameral adrenaline intraoperatively, in addition to topical mydriatics, and cases that received topical mydriatics only. In addition, this study aimed at assessing the systemic and local side effects of the two techniques.
Patients and methods The study was conducted on a total of 80 consecutive eyes that underwent phacoemulsification surgery. Patients with different types of cataract requiring phacoemulsification were included in this study. The patients were randomized and divided into two groups. The first group (50 cases) received intraoperative bolus adrenaline injection intracameraly, in addition to preoperative topical mydriatics. The pupil diameter was measured twice, once after topical mydriatics and the second time after intracameral adrenaline injection. The second group (30 cases) received benoxinate hydrochloride 4 mg (Benox) preoperatively as a topical anesthetic, and tropicamid 1% (Mydriacil) as mydriatic. The pupil diameter was measured by using a squint caliper after mydriacyl.
Results The mean preoperative pupil diameter in the first group was 6.76 ± 0.90 mm. Patients in the first group had smaller pupils. The mean preoperative pupil diameter in the second group was 8.07 ± 0.68 mm. The difference between the two groups was statistically significant. On the other hand, the mean pupil diameter after intracameral adrenaline injection was 7.91 ± 1.01 mm, which was statistically different as adrenaline dilated the pupil.
Conclusion The present study revealed better pupil dilatation in cases with narrower pupil when injected with intracameral adrenaline than in cases with topical mydriatic only, with no local or systemic side effects.